Drug therapy and other factors associated with the development of acute kidney injury in critically ill patients: a cross-sectional study.

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dc.creatorDanielly Botelho Soares
dc.creatorJuliana Vaz de Melo Mambrini
dc.creatorGabriela Rebouças Botelho
dc.creatorFlávia Fialho Girundi
dc.creatorFernando Antônio Botoni
dc.creatorMaria Auxiliadora Parreiras Martins
dc.date.accessioned2024-09-16T15:21:50Z
dc.date.accessioned2025-09-08T23:18:02Z
dc.date.available2024-09-16T15:21:50Z
dc.date.issued2018
dc.format.mimetypepdf
dc.identifier.doi10.7717/peerj.5405
dc.identifier.issn2167-8359
dc.identifier.urihttps://hdl.handle.net/1843/76484
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofPeerJ
dc.rightsAcesso Aberto
dc.subjectPrática clinica
dc.subjectFalência renal crônica
dc.subjectSáude pública
dc.subjectNefrologia
dc.subjectCuidados intensivos
dc.subjectPrática clinica
dc.subject.otherNephrology
dc.subject.otherPharmacology
dc.subject.otherPublic health
dc.subject.otherCritical care
dc.subject.otherDrug utilization
dc.subject.otherClinical practice
dc.titleDrug therapy and other factors associated with the development of acute kidney injury in critically ill patients: a cross-sectional study.
dc.typeArtigo de periódico
local.citation.epage19
local.citation.spage1
local.citation.volume6
local.description.resumoBackground: Acute kidney injury (AKI) is associated with a significant increase in morbidity, mortality, and health care costs. In intensive care units (ICU), AKI is commonly multifactorial and frequently involves diverse factors, such as hypovolemia, sepsis, and the use of nephrotoxic drugs. We aimed to investigate drug therapy and other factors associated with the development of AKI in a Brazilian public hospital. Methods: This is a cross-sectional study involving critically ill patients at an ICU of a tertiary hospital. All data on sequential serum creatinine (SCr) level, glomerular filtration rate (GFR), and urine output were collected during ICU stay. The primary outcome was the occurrence of AKI assessed by the Acute Kidney Injury Network (AKIN) criterion. Sociodemographics, clinical data and drug therapy were considered as covariates. Factors associated with AKI were assessed using logistic regression. Results: Overall, 122 participants were included in the study. Median age was 46.0 (interquartile range, IQ = 29.0-69.0) years, with a predominance of men (58.2%). Mean number of prescribed drugs throughout ICU stay was 22.0 ± 9.4. The number of potentially nephrotoxic drugs ranged from two to 24 per patient. A total of 29 (23.8%) ICU patients developed AKI. In the AKI-group, patients were older and showed higher Acute Physiology and Chronic Health Evaluation II (APACHE II) scores at admission, higher rates of sedation, mechanical ventilation, and infection. More drugs in general and specifically more vasoactive drugs were prescribed for AKI group. Patients who developed AKI tended to have extended stays in the ICU and a lower probability of being discharged alive than patients with no AKI development. Model adjustments of logistic regression showed that the number of medications (OR 1.15; 95% CI [1.05-1.27]) was the only factor associated with AKI in this study. This association was independent of drug nephrotoxicity. Discussion: Intensive care is characterized by its complexity that combines unstable patients, severe diseases, high density of medical interventions, and drug use. We found that typical risk factors for AKI showed statistical association on bivariate analysis. The contribution of drug therapy in the occurrence of AKI in medical ICUs reinforces the need for prevention strategies focused on early recognition of renal dysfunction and interventions in drug therapy. These actions would help improve the quality of patient care and ensure progress towards medication safety.
local.publisher.countryBrasil
local.publisher.departmentFAR - DEPARTAMENTO DE PRODUTOS FARMACÊUTICOS
local.publisher.departmentMED - DEPARTAMENTO DE CLÍNICA MÉDICA
local.publisher.initialsUFMG
local.url.externahttps://peerj.com/articles/5405/#

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